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Consolidated School Report of The Visual Acuity Results: Elementary Secondary S.Y.: 2018 - 2019

The document is a school report summarizing the results of a visual acuity screening for students. It shows the number of students screened and their results in different grades for the school year 2018-2019. The summary section at the bottom is blank, intended to be filled in with the total numbers of students with defects and normal vision, males and females screened and enrolled, after collecting the results from the tables.

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Rebecca Vibar
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201 views6 pages

Consolidated School Report of The Visual Acuity Results: Elementary Secondary S.Y.: 2018 - 2019

The document is a school report summarizing the results of a visual acuity screening for students. It shows the number of students screened and their results in different grades for the school year 2018-2019. The summary section at the bottom is blank, intended to be filled in with the total numbers of students with defects and normal vision, males and females screened and enrolled, after collecting the results from the tables.

Uploaded by

Rebecca Vibar
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as XLSX, PDF, TXT or read online on Scribd
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Department of Education

Region VII, Central Visayas


DIVISION OF CEBU

CONSOLIDATED SCHOOL REPORT OF THE VISUAL ACUITY RESU


( ) Elementary ( ) Secondary
S.Y.: 2018 - 2019
SCHOOL: DISTRICT:
NUTRITION COORDINATOR / F.A.T.: ADMINISTRATOR:

HEADACHE / VISUAL ACUITY RESULTS


DIZZINESS WHEN SQUINT
GRADE / YEAR READING WITH EYEGLASSES WITHOUT EYEGLA
LEVEL NUMBER NUMBER RIGHT EYE LEFT EYE RIGHT EYE
YES NO YES NO READING M F READING M F READING M F
GRADE 1 / 1ST YR M F M F M F M F 20 / 200 20 / 200 20 / 200
ENROLMENT 20 / 60 20 / 60 20 / 60
M F 20 / 40 20 / 40 20 / 40
TOTAL = 20 / 30 20 / 30 20 / 30
TOTAL NO. WITH DEFECTS
TOTAL NUMBER W/ NORMAL VISION 20 / 20 20 / 20 20 / 20

GRADE 2 / 2ND YR M F M F M F M F 20 / 200 20 / 200 20 / 200


ENROLMENT 20 / 60 20 / 60 20 / 60
M F 20 / 40 20 / 40 20 / 40
TOTAL = 20 / 30 20 / 30 20 / 30
TOTAL NO. WITH DEFECTS
TOTAL NUMBER W/ NORMAL VISION 20 / 20 20 / 20 20 / 20

GRADE 3 / 3RD YR M F M F M F M F 20 / 200 20 / 200 20 / 200


ENROLMENT 20 / 60 20 / 60 20 / 60
M F 20 / 40 20 / 40 20 / 40
TOTAL = 20 / 30 20 / 30 20 / 30
TOTAL NO. WITH DEFECTS
TOTAL NUMBER W/ NORMAL VISION 20 / 20 20 / 20 20 / 20

GRADE 4 / 4TH YR M F M F M F M F 20 / 200 20 / 200 20 / 200


ENROLMENT 20 / 60 20 / 60 20 / 60
M F 20 / 40 20 / 40 20 / 40
TOTAL = 20 / 30 20 / 30 20 / 30
TOTAL NO. WITH DEFECTS
TOTAL NUMBER W/ NORMAL VISION 20 / 20 20 / 20 20 / 20

GRADE 5 / GR XI M F M F M F M F 20 / 200 20 / 200 20 / 200


ENROLMENT 20 / 60 20 / 60 20 / 60
M F 20 / 40 20 / 40 20 / 40
TOTAL = 20 / 30 20 / 30 20 / 30
TOTAL NO. WITH DEFECTS
TOTAL NUMBER W/ NORMAL VISION 20 / 20 20 / 20 20 / 20

GRADE 6 / GR XII M F M F M F M F 20 / 200 20 / 200 20 / 200


ENROLMENT 20 / 60 20 / 60 20 / 60
M F 20 / 40 20 / 40 20 / 40
TOTAL = 20 / 30 20 / 30 20 / 30
TOTAL NO. WITH DEFECTS
TOTAL NUMBER W/ NORMAL VISION 20 / 20 20 / 20 20 / 20
SUMMARY:
TOTAL NO. WITH DEFECTS: MALE: FEMALE: TOTAL:
TOTAL NO. WITH NORMAL VISION: MALE: FEMALE: TOTAL:
TOTAL NO. SCREENED: MALE: FEMALE: TOTAL:
TOTAL ENROLMENT: MALE: FEMALE: TOTAL:

PREPARED BY: NOTED:

SCHOOL NUTRITION COORDINATOR / F. A. T SCHOOL HEAD


TY RESULTS

TOTAL
OUT EYEGLASSES NUMBER
SCREENED
LEFT EYE
READING M F M F T
20 / 200
20 / 60
20 / 40
0
20 / 30

20 / 20

20 / 200
20 / 60
20 / 40
0
20 / 30

20 / 20

20 / 200
20 / 60
20 / 40
0
20 / 30

20 / 20

20 / 200
20 / 60
20 / 40
0
20 / 30
0

20 / 20

20 / 200
20 / 60
20 / 40
0
20 / 30

20 / 20

20 / 200
20 / 60
20 / 40
0
20 / 30

20 / 20

CHOOL HEAD:
Department of Education
Region VII, Central Visayas
DIVISION OF CEBU

VISION TEST ACUITY RESULTS


S.Y. 20___ - 20___

SCHOOL: DISTRICT: DATE EXAMINED:


GRADE / LEVEL: SECTION:

HEADACHE, READING RESULTS


NAUSEA, SQUINT

KS
NAME of PUPILS /
AGE SEX

AR
DIZZINESS WITH EYEGLASSES W/OUT EYEGLASSES
STUDENTS

EM
YES NO YES NO ( R) EYE ( L) EYE ( R) EYE ( L) EYE

R
PREPARED BY:

Class Adviser

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